An anchor assembly having a helical anchor extending through an anchor bore defined in the anchor housing. In some embodiments, at least one helical turn of the helical anchor extends beyond a portion of the anchor bore. In some embodiments, at least one helical turn of the helical anchor extends beyond a side wall of the anchor housing. In some embodiments, the helical turns of the helical anchors of anchor assemblies mounted adjacent one another on an implantable device nest within one another when the implantable device is in an unexpanded configuration. In some embodiments, the distalmost helical turn of the helical anchor has an outer diameter greater than more proximal helical turns of the helical anchor. In some embodiments, the outer diameters of the at least some of the helical turns of the helical anchor taper from a distal end to a proximal end of the helical anchor.

An implantable device which shifts between a collapsed configuration and an expanded configuration. The implantable device may be delivered transluminally in a collapsed delivery configuration to a treatment site, whereupon the implantable device may be expanded to a deployment configuration. As the implantable device is expanded to the deployment configuration, the proximal end of the implantable device remains coupled to a delivery and/or deployment device. The implantable device is configured such that while the proximal end may be constrained by being coupled to the delivery device, the distal end is not impeded from expanding to within greater than 90% of its fully expanded configuration when not coupled to the delivery device.

A mitral valve prosthesis is percutaneously and/or transapically deployed in at least two stages. In a first stage, a mitral annular ring platform adapted for percutaneous delivery is delivered to and anchored in the mitral valve annulus. In the second stage, a valved-stent mitral valve prosthetic device adapted for percutaneously delivery is delivered to the mitral valve annulus for mounting in the mitral annular ring platform. This approach provides a consistent platform for accepting valved-stent mitral valve prosthetic devices from different vendors to be used.

A method for use with a heart of a subject includes advancing a tool distally along a flexible elongate contracting member, toward an anchor implanted at the heart. Tension is applied to the contracting member such that the contracting member slides proximally through a fastener disposed at the heart while a stop coupled to the fastener maintains the fastener in an open state. Using the tool, the stop is pulled proximally (i) away from the fastener, such that the fastener responsively clamps to the contracting member, thereby locking the tension in the contracting member, and (ii) against a cutting element of the tool such that the cutting element moves in a manner that severs the contracting member. Other embodiments are also described.

An anchoring system including an anchoring assembly having two or more anchor elements, and anchor drive mechanism having a respective actuator portion couplable with each anchor element and operable to separately and independently actuate each anchor element. In some embodiments, the actuator portions are on different portions of a common actuator component. The actuator portions actuate the anchor elements by different actuation movements. Is some embodiments, the actuator portions use different types of actuation movements, such as rotational motion to actuate one anchor element, and axial motion to actuate another anchor element. The actuator portions may be formed on different portions of a common actuator component, or as different structures coupled together.

A valve implant includes an occlusive assembly and a frame coupled to the occlusive assembly. The frame transitions from a collapsed state to an expanded state about a central longitudinal axis and transitioning from the collapsed state to the expanded state causes a proximal end of the frame to expand radially outward from the central longitudinal axis. The valve implant further includes an outer sheet supported on a proximal portion of the frame. The occlusive assembly is supported on a distal portion of the frame such that the inner sheet extends about the central longitudinal axis and an annular opening is defined between the outer sheet and the inner sheet when the frame is in the expanded state.

The invention relates to a device for use in the transcatheter treatment of mitral valve regurgitation, specifically a coaptation assistance element for implantation across the valve; a system including the coaptation assistance element and anchors for implantation; a system including the coaptation assistance element and delivery catheter; and a method for transcatheter implantation of a coaptation element across a heart valve.

A method of treating diastolic heart failure includes implanting a cardiac implant in a heart of a subject diagnosed as suffering from diastolic heart failure. A superior portion of a flexible tether of the cardiac implant is anchored to one or more left-atrial sites of one or more walls of the left atrium. An inferior portion of the flexible tether is anchored to a site of a wall of a mid third of the left ventricle, of a wall of an apical third of the left ventricle, and/or of a papillary muscle of the left ventricle. As a result, the flexible tether reduces a volume of the left atrium during at least a portion of ventricular diastole of each cardiac cycle, thereby enhancing ventricular filling. Other embodiments are also described.

Apparatus is provided for use at a native atrioventricular valve of a heart of a subject. A prosthetic valve structure includes prosthetic leaflets configured to facilitate upstream-to-downstream bloodflow longitudinally through the prosthetic valve structure. The apparatus includes an annular portion configured to be positioned at the native atrioventricular valve and curved anchors that point in a circumferential direction around the annular portion. The anchors each having a leading tip configured to gather chordae tendineae of the heart between the anchors and the annular portion. Rotation of the prosthetic valve structure in the circumferential direction causes the anchors to gather the chordae tendineae between the anchors and the annular portion by the anchors moving, leading tip first, in the circumferential direction. Other embodiments are also described.

An example anchor-manipulation tool includes (i) at a distal portion of the tool, an anchor-engaging element and an actuator, (ii) at an extracorporeal proximal portion of the tool, a controller, and (iii) a flexible longitudinal member extending between the proximal portion and the distal portion. The distal portion of the tool can be transluminally advanced to an anchor that is intracorporeally implanted in a subject. Subsequently, the anchor-engaging element can be engaged with an eyelet defined by a head of the anchor. Subsequently, the controller can be used to transition the tool into an articulatably-coupled state in which: (i) the eyelet at least in part inhibits movement of the anchor-engaging element away from the anchor, and (ii) the distal portion of the anchor-manipulation tool is deflectable with respect to the anchor. Subsequently, the anchor can be de-anchored by using the anchor-manipulation tool to apply a de-anchoring force to the eyelet.